Condyloma and Condyloma Acuminatum
HPV-related exophytic papillomatous epithelial proliferation (Calonje 2011).
Median of 200 affected patients per 100,000 inhabitants (male and female) (Patel et al. 2013).
Sexually active young adults (3rd–4thdecade), rare in older patients.
Male and female adults.
Most cases (85%) are related to low-risk HPV genotypes 6 and 11. High risk genotypes (16, 18, and others) are more common in patients with multiple sexual partners.
Glans, coronal sulcus, foreskin, meatus, scrotum (men), and even urethra or urinary bladder (men and women) for direct extension.
Cryotherapy, laser therapy, or local surgical excision for small circumscribed lesions. Extensive surgery is required for giant destructive condylomas.
Good but recurrence is not uncommon, especially for individuals with multiple sexual partners (Thomas et al. 2017).
Malignant transformation is very rare (Botella et al. 2000) and may occur specially in giant destructive long-standing lesions. Such lesions exhibit foci of usual squamous carcinoma especially at tumor base.
Small pink/greyish exophytic lesions are the most common presentation (condyloma acuminatum). Other possible forms are flat and giant condylomas (Amin 2016).
Low-risk HPV types 6–11 on in situ hybridization and PCR investigations, other types have been infrequently reported.
Papillomatosis of the glans corona: Common papules occurring in young sexually active men. They appear as HPV negative multiple small papillomas arranged along the corona.
Seborrheic keratosis: HPV-negative lesions characterized by parakeratosis and acanthosis; no koilocytes are found.
PeIN (Penile Intraepithelial Neoplasia): This premalignant lesion may simulate flat condyloma. PeIN can be classified in differentiated forms, negative for HPV or p16, and HPV-related forms.
Warty Carcinoma: HPV-related carcinoma whose cells display pleomorphism, p16 positivity and carry high-risk HPV genotypes. It may be confused with giant condylomas.
Papillary carcinoma and verrucous carcinoma: Non-HPV-related carcinomas that may simulate condylomatous papillae. The tumor base is infiltrative in papillary subtypes and broad in verrucous subtypes (like in condylomas). HPV and p16 expression is negative in both lesions.